HomeMy Public PortalAboutBUTLER AV_1515 a'taM�'
CITY OF TYBEE ISLAND
BUILDING PERMIT
DATE ISSUED: 03-28-2013 PERMIT#: 130192
WORK DESCRIPTION TENANT SEPARATION WALL
WORK LOCATION 1515 BUTLER AVE
OWNER NAME BENNY'S/TYBEE TAVERN&REST.
ADDRESS PO BOX 2048
CITY,ST,ZIP TYBEE ISLAND GA 31328
PHONE NUMBER 912-786-0121
CONTRACTOR NAME DIVERSIFIED DESIGNS
ADDRESS 11 JONES AVE
CITY STATE ZIP TYBEE ISLAND GA 31328
FLOOD ZONE
BUILDING VALUATION
SQUARE FOOTAGE
OCCUPANCY TYPE U
TOTAL FEES CHARGED $ 135.00
PROPERTY IDENTIFICATION# PIN#4-0008-07-009
PROJECT VALUATION $3,500.00
TOTAL BALANCE DUE: $ 135.00
It is understood that if this permit is granted the builder will at all times comply with the zoning,subdivision,flood control,building,fire,soil
and sedimentation,wetlands,marshlands protection and shore protection ordinances and codes whether local,state or federal,including all
environmental laws and regulations when applicable,subsequent owners should be informed that any alterations to the property must be
approved by the issuance of another building permit. Permit holder agrees to hold the City of Tybee Island harmless on any construction
covered by this permit.
This permit must be posted in a conspicuous location in the front of building and protected from the weather. If this permit is not posted work
will be stopped. The building contractor will replace curb paving and gutter broken during construction. This permit will be voided unless
work has begun within six months of the date of issuance.
Signature of Building Inspector or Authorized Agent: (j� d
P.O.Box 2749-403 Butler Avenue,Tybee Island,Georgia 31328
(912)786-4573-FAX(912)786-9539
www.cityoftybee.org
4Ao, City of Tybee Island • Planning & Zoning Dept. c l,
._h ' i Inspection Report :I1>♦q
�; 403 Butler Ave. •• P.O. Box 2749 •• Tybee Island, GA 31328 i�r~ho
Phone 912.472.5032 • Fax 912.786.9539 CODE COUNCIL'
/ / MEMBER
Permit No -(2/1712, Date Requested / ')///:.;
Owner's Name /\,1-� Date Needed
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Gen. Contractor ,. / r'/ AZ-J'!.-.J '> Subcontractor
Contact Information "----/),:::,-, e/� 4,/ - /9 5
Project Address / / ,- !-_%=-
Scope of Work � r i f / 7 � 1-ij,4//
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Inspector --2/1 Date of Inspection ,1 / //, -,
o- ,. �� , T.._..,
Inspection / /- �J 3• I Pass -� il Fee
Inspection Pass ❑ Fail ❑ Fee
Inspection Pass El Fail El Fee
Inspection Pass ❑ Fail ❑ Fee
City of Tybee Island • Planning & Zoning Dept.
Inspection Report owasZt
■,s,'
I i 1 emartEssi
„ 403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 INTERNTONAL
-",;if/ Phone 912.472.5032 • Fax 912.786.9539 CODE COUNCIL.
/ MEMBER
Permit No. / 5 . (--_-/ -7 c ,-- Date Requested
-- -_- i
Owner's Name Date Needed
Gen. Contractor i-)) !) / )/2_5/l--63 Subcontractor
Contact Information , _ -.7 _- '--i • ' / , ' ,-
Project Address i--, P--, )_,,■)--/-1
Scope of Work .--:--)Tr-_1-s,--)77A.-,L--,(_:,-,.) fAja-i /
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Inspector 1 I g Date of Inspection ,6
Inspection —
_..... LI--4 1 .Z. - Pass III ‘tajl El Fee
Inspection Pass 1=1 Fail El Fee
Inspection Pass El Fail 0 Fee
Inspection Pass 0 Fail 0 Fee
�.�LrF ��.� �al., ICC
/, "�\ City of Tybee Island • Planning & Zoning Dept. :�� °:`
). I Inspection Report m®
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403 Butler Ave. • P.O. Box 2749 • Tybee Island, GA 31328 FRFJATIO Ai IN Phone 912.472.5032 • Fax 912.786.9539 COBECOUNCIL
MEMBER
Permit No. /3-01Q,1_ Date Requested d 1-71/41/i//3
Owner's Name B-- JVrV! Date Needed oi//x51/3
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Gen. Contractor �_ � Subcontractor
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Contact Information 11 C7(5 -'Z'-
Project Address 15)� f /if7L k.
Scope of Work °S[ AteTIo'-0 ( )4L-.
Inspector Date of Inspection PS
Inspection IV 1.(/,4[ '- I'0- 'l' Pass Et Ei Fee
Inspection Pass 0 Fail ❑ Fee
Inspection Pass 0 Fail ❑ Fee
Inspection Pass ❑ Fail 0 Fee
— BXU V.U415 - Fire Resistance Ratings - ANSI/UL 263 Page 1 of 8
s � c : lisS ► i •1 : _.,
Design No. U415 ''- f:g `
zXUV.U415 el
Fire t esistance ratings - ANSI/UL 263 v
Page Bottom
4 i
i Design/System/Construction/Assembly Usage Disclaimer —: Z
• Authorities Having Jurisdiction should be consulted in all cases as to the particular requirements covering the installation anf UL
Listed or Classified products,equipment,system,devices,and materials.
• Authorities Having Jurisdiction should be consulted before construction.
• Fire resistance assemblies and products are developed by the design submitter and have been investigated by UL for compliance with
applicable requirements.The published information cannot always address every construction nuance encountered in the field.
• When field issues arise,it is recommended the first contact for assistance be the technical service staff provided by the product
manufacturer noted for the design.Users of fire resistance assemblies are advised to consult the general Guide Information for each
product category and each group of assemblies.The Guide Information includes specifics concerning alternate materials and alternate
methods of construction.
• Only products which bear UL's Mark are considered as Classified,Listed,or Recognized.
Fire-resistance Ratings - ANSI/UL 263
See General Information for Fire-resistance Ratings-ANSI/UL 263
Design No. U415
March 18,2013
1 Nonbearing Wall Ratings—1,2,3 or 4 Hr
r-e
System A ---- A Hr.
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= -+.► ryd in.. yr ii130 rnra, O.C. --0,-;
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System 13 — 2 Hr.
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t3XU V.U4 1 5 - Fire Resistance Ratings - ANSI/UL 263 Page 2 of 8
. .
System C — 2 Ht.
,---....
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,, ,,,) ., ,- -,
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; ,,,,. .., ,„›....- 2 ,
H 24 in. or 6.1Rill wm 0_C ----i-4
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://:••• . .-----' .„.„ •-,:•" :':::::, ; . --:_:-_- --_,:.2.11,-L:-.....-..,_:::_-_:;,.:..-____."..-_:.._-_,.:-.z,,,... ..-.4.• ... ..-_,...4,:-,...,,:;;.
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System F — 2 Fir.
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24 In.- qr •r.g3 Tam 0.C. ---*'-k
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13XU V.U415 - Fire Resistance Ratings- ANSI/UL 263 Page 3 of 8
Sy stem U mm 3 Hr,
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.
'' -:,: :......... . .. : .' ._:.„ . •• • ;- :- •..r °-;•.,...,: •.u.... ,j1 :-• -- -,�ref.
.r I- ,ri o uI Swjtiou
1.Floor,Side and Ceiling Runners—"3"-shaped runner,min 2-1/2 in.deep(min 4 in.deep when System C is used),
with unequal legs of 1 in.and 2 in.,fabricated from min 24 MSG(min 20 MSG when Item 4A,4B or 7 are used)galv steel.
Runners positioned with short leg toward finished side of wall.Runners attached to structural supports with steel fasteners
located not greater than 2 in.from ends and not greater than 24 in, OC."E"-shaped studs(Item 2A)may be used as side
runners in place of"3"-shaped runners.
2.Steel Studs—"C-H"-shaped studs,min 2-1/2 in.deep(min 4 in.deep when System C is used), fabricated from min
25 MSG(min 20 MSG when Items 2D,4A,4B or 7 is used)gale steel.Cut to lengths 3/8 to 1/2 in.less than floor-to-ceiling
height and spaced 24 in.or 600 mm OC.
2A.Steel Studs—(Not Shown)—"E"-shaped studs installed back to back in place of"C-H"-shaped studs(Item 2)"E"-
shaped studs secured together with steel screws spaced a maximum 12 in.OC.Fabricated from min 25 MSG(min 20 MSG
when Item 2D,4A,4B or 7 is used)galv steel,min 2-1/2 in.deep(min 4 in.deep when System C is used),with one leg 1
• in. long and two legs 3/4 in.long.Shorter legs 1 in.apart to engage gypsum liner panels.Cut to lengths 3/8 to 1/2 in.less
than floor to ceiling heights.
2B.Furring Channels—(Optional,not shown)—For use with single or double layer systems.Resilient furring channels
fabricated from min 25MSG corrosion protected steel,installed horizontally,and spaced vertically a max 24 in.OC.Flange
portion of channel attached to each intersecting"C-H"or"E"stud on side of stud opposite the 1 in.liner panels with 1/2 in.
long Type S or S-12 pan-head steel screws.When furring channels are used,wallboard to be installed vertically only.Not to
be used with Type FRX-G gypsum wallboard,Type RB-LBG(Item 4A),Type Nelco(Item 4B)or cementitious backer units
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tiAU V.U4 1.5 - Fire Resistance Ratings - ANSI/UL 263 Page 4 of 8
(Item 7).
2C.Furring Channels—For use with System I-"Hat"-shaped,25 MSG galv steel furring channels attached directly over
the inner layers of wallboard to each stud with 2 in.long Type S pan head steel screws.Screws alternate from top flange to
bottom flange at each stud intersection.Furring channels spaced vertically max 24 in.OC.
2D.Steel Framing Members*—(Optional,not shown)—For use with single or double layer systems.Furring channels
and Steel Framing Members as described below.Not to be used with Type FRX-G gypsum wallboard,Type RB-LBG(Item
4A),Type Nelco(Item 48)or cementitious backer units(Item 7):
a.Furring Channels—Formed of No.25 MSG galv steel.2-9/16 in.or 2-23/32 in.wide by 7/8 in.
deep,spaced max.24 in.OC perpendicular to studs.Channels secured to studs as described in
Item b.Gypsum board installed vertically only and attached to furring channels as described in
Item 3.
b.Steel Framing Members*—Used to attach furring channels(Item 2Da)to studs(Item 2 or
2A).Clips spaced max.24 in.OC.,and secured to studs with No.8 x 1-1/2 in.minimum self-
drilling,5-12 steel screw through the center grommet.Furring channels are friction fitted into clips.
RSIC-1 clip for use with 2-9/16 in.wide furring channels.RSIC-1 (2.75)clip for use with 2-23/32
in.wide furring channels.
PAC INTERNATIONAL INC—Types RSIC-1,RSIC-1(2.75).
3.Gypsum Board*—Gypsum liner panels,nom 1 in.thick,24 in.or 600 mm(for metric spacing)wide.Panels cut 1 in.
less in length than floor to ceiling height.Vertical edges inserted in"H"portion of"C-H"studs or the gap between the two
3/4 in.legs of the"E"studs.Free edge of end panels attached to long leg of vertical"3"-runners with 1-5/8 in.long Type
S steel screws spaced not greater than 12 in.OC.When wall height exceeds liner panel length,liner panel may be butted
to extend to the full height of the wall.Horizontal joints need not be backed by steel framing.In System I,butt joints in
liner panels are staggered min 36 in.Butt joints backed with 6 in.by 22 in.strips of 3/4 in.thick gypsum wallboard(Item
4).Wallboard strips centered over butt joints and secured to liner panels with six 1-1/2 in.long Type G steel screws,three
screws along the 22 in.dimension at the top and bottom of the strips.
CGC INC—Type SLX
UNITED STATES GYPSUM CO—Type SLX
USG MEXICO S A DE C V—Type SLX
4.Gypsum Board* —
System A-1 Hr
Gypsum panels,with beveled,square or tapered edges,nom 5/8 in.thick,48 in.or 1200 mm wide,applied vertically or
horizontally,attached to studs with 1 In.long Type S steel screws spaced 12 in.when installed vertically or 8 in OC when
installed horizontally.Horizontal joints need not be backed by steel framing.
CGC INC—Types AR,C,IP-AR,IP-X1,IP-X2,IPC-AR,5CX,SHX,ULX,WRC,WRX
UNITED STATES GYPSUM CO—Types AR,C,FRX-G,IP-AR, IP-X1,IP-X2,IPC-AR,SCX,SGX,SHX, ULX,WRC,WRX,
USGX.
USG MEXICO S A DE C V—Types AR,C,IP-AR,IP-X1,IP-X2,IPC-AR,SCX,SHX,ULX,WRC,WRX
System B-2 Hr
Gypsum panels,with beveled,square or tapered edges,nom 1/2 in.or 5/8 in.thick,48 in.or 1200 mm wide,applied
vertically or horizontally in two layers.Inner or base layer attached to studs with 1 in.long Type S steel screws spaced 24
in.OC when installed vertically or 16 in.OC when installed horizontally.Outer or face layer attached to studs with 1-5/8 in.
long Type S steel screws spaced 12 in.OC when installed vertically and staggered 12 in.from base layer screws or 8 in.OC
when installed horizontally and staggered 8 in.from base layer screws.Horizontal joints between inner and outer layers
staggered a min of 12 in.Horizontal joints need not be backed by steel framing.Vertical joints centered over studs and
staggered 24 in.
CGC INC— 1/2 in.Type C,IP-X2,IPC-AR or WRC; 5/8 in.Types AR,C,IP-AR,IP-X1,IP-X2,IPC-AR,SCX,SHX,ULX,
WRC,WRX
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13XU V.U415 - Fire Resistance Ratings - ANSI/UL 263 Page 5 of 8
UNITED STATES GYPSUM CO— 1/2 in.Types C,IP-X2,IPC-AR,or WRC; 5/8 in.Types AR,C, FRX-G,IP-AR,IP-X1,IP-
X2,IPC-AR,SCX,SGX,SHX, ULX, USGX,WRC,WRX
USG MEXICO S A DE C V— 1/2 in.Types C,IP-X2, IPC-AR or WRC; 5/8 in.Types AR,C, IP-AR,IP-X1,IP-X2,IPC-AR,
SCX,SHX,ULX,WRC,WRX
System C-2 Hr
Gypsum panels,with beveled,square or tapered edges,nom 3/4 in. thick,48 in.or 1200 mm wide,applied vertically or
horizontally,secured with 1-1/4 in. long Type S steel screws spaced 8 in.OC along vertical edges and 12 in.OC in the field
when installed vertically or 8 in.OC along the vertical edges and in the field when installed horizontally.Horizontal joints
need not be backed by steel framing.Screws along side joints offset 4 in.Requires min 4 in.deep framing per Items 1,2
and 3.Requires min 3 in.thick mineral wool batts per Item 6.
CGC INC—Types IP-X3,or ULTRACODE
UNITED STATES GYPSUM CO—Types IP-X3,or ULTRACODE
USG MEXICO S A DE C V—Types IP-X3,or ULTRACODE
System D-2 Hr
Gypsum panels,with beveled,square or tapered edges,nom 5/8 in.thick,48 in.or 1200 mm wide,applied vertically or
horizontally,attached directly to studs with 1 in. long Type S steel screws spaced 24 in.when installed vertically or 16 in.
OC when installed horizontally. . Horizontal joints need not be backed by steel framing.Requires face layer of 1/2 or 5/8 in.
thick cementitious backer units per Item 7 and min 1-1/2 in.thick mineral wool batts per Item 6.
CGC INC—Types AR,C,IP-AR,IP-X1,IP-X2,IPC-AR,SCX,SHX, ULX,WRC,WRX
UNITED STATES GYPSUM CO—Types AR,C,FRX-G,IP-AR,IP-X1,IP-X2,IPC-AR,SCX,SGX,SHX,ULX,USGX,WRC,
WRX.
USG MEXICO S A DE C V—Types AR,C,IP-AR,IP-X1,IP-X2,IPC-AR,SCX,SHX,ULX,WRC,WRX
System E-2 Hr
Gypsum panels, with beveled,square or tapered edges,nom 1/2 in,or 5/8 in.thick,48 in.or 1200 mm wide,applied
vertically or horizontally,attached to studs with 1 in.long Type S steel screws spaced 12 in.OC when installed vertically or
8 in.when installed horizontally.Horizontal joints need not be backed by steel framing.
CGC INC—1/2 in.Types C,IP-X2,IPC-AR; 5/8 in.Types AR,C,IP-AR,IP-X1,IP-X2,IPC-AR,SCX,SHX,ULX,WRC,WRX
UNITED STATES GYPSUM CO—1/2 in.Types C,IP-X2,IPC-AR; 5/8 in.Types AR,C,FRX-G,IP-AR,IP-X1,IP-X2,IPC-
AR,SCX,SGX,SHX,ULX,USGX,WRC,WRX.
USG MEXICO S A DE C V— 1/2 in.Types C,IP-X2,IPC-AR; 5/8 in.Types AR,C, IP-AR,IP-X1,IP-X2,IPC-AR,SCX,51-IX,
ULX,WRC,WRX
System F-2 Hr
Gypsum panels,with beveled,square or tapered edges,nom 1/2 in.or 5/8 in.thick,48 in.or 1200 mm wide,applied
vertically in two layers.Inner or base layer attached to resilient furring channels(Item 2B)with 1 in.long Type S steel
screws spaced 24 in.Outer or face layer attached to resilient furring channels(Item 28)with 1-5/8 in.long Type S steel
screws spaced 12 in.OC and staggered 12 in.from base layer screws.Joints between inner and outer layers staggered 24
in.
CGC INC— 1/2 in.Type C, IP-X2,IPC-AR or WRC; 5/8 in.Types AR,C,FRX-G,IP-AR,IP-X1,IP-X2,IPC-AR,SCX,SHX,
ULX,WRC,WRX
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BXUV.U415 -Fire Resistance Ratings -ANSI/UL 263 rage i of
Il
RAY-BAR ENGINEERING CORP—Type RB-LBG
4B.Gypsum Board*—(As an alternate to Item 4 Systems A,8,C,D,E,G,H,and I when used as the base layer,For
direct attachment only)-Nominal 5/8 in.thick lead backed gypsum panels with beveled,square or tapered edges,applied
vertically.Vertical joints centered over studs and staggered min 1 stud cavity on opposite sides of studs.Wallboard secured
to studs with 1-1/4 in.long Type S-12(or#6 by 1-1/4 in.long bugle head fine driller)steel screws spaced 8 in.OC at
perimeter and 12 in.OC in the field.
NEW ENGLAND LEAD BURNING CO INC,DBA NELCO—Nelco
4C.Gypsum Board*—(As an alternate to Item 4 Systems A,B,C,D,E,G,11,and I when used as the base layer,For
direct attachment only)-Nom 5/8 or 3/4 in.thick lead backed gypsum panels with beveled,square or tapered edges,
applied vertically.Vertical joints centered over 20 MSG steel studs and staggered min 1 stud cavity on opposite sides of
studs.See Items 1,2,2A,2B and 2D.Wallboard secured to studs with 1-1/4 in.long Type S-12 steel screws spaced 8 in.
OC at perimeter and 12 in.OC in the field.For Joint Compound see Item 5.To be used with Lead Batten Strips(see Item
9A)or Lead Discs(see Item 10A).Lead batten strips required behind vertical joints of lead backed gypsum wallboard and
optional at remaining stud locations.Lead batten strips,min 2 in.wide,max 10 ft long with a max thickness of 0.140 in.
placed on the face of studs and attached to the stud with two 1 in.long Type S-8 pan head steel screws,one at the top of
the strip and one at the bottom of the strip.
MAYCO INDUSTRIES INC—Type X-Ray Shielded Gypsum
4D.Gypsum Board*—(As an alternate to Item 4 Systems A,B,C,0,E,G, H,and I when used as the base layer,For
direct attachment only).Nom 5/8 in.thick lead backed gypsum panels with beveled,square or tapered edges,applied
vertically.Vertical joints centered over studs and staggered min 1 stud cavity on opposite sides of studs.Wallboard secured
to studs with 1-1/4 in.long Type S-12 steel screws gypsum panel steel screws spaced 8 in. OC at perimeter and 12 in.OC
in the field.Lead batten strips required behind vertical joints of lead backed gypsum wallboard and optional at remaining
stud locations.Lead batten strips,min 2 in.wide,max 8 ft long with a max thickness of 0.14 in.placed on the face of studs
and attached to the stud with construction adhesive and two 1 in.long Type S-12 pan head steel screws,one at the top of
the strip and one at the bottom of the strip.Lead discs,nominal 3/8 in.diam by max 0.085 in.thick.Compression fitted or
adhered over the screw heads.Lead batten strips and discs to have a purity of 99.9%meeting the Federal specification
QQ-L-201f,Grade"C".
RADIATION PROTECTION PRODUCTS INC—Type RPP-Lead Lined Drywall
5.Joint Tape and Compound—(Not Shown)
Systems A,B,C,E,F,G,H,I
Joints on outer layers of gypsum boards(Item 4 and 4A)covered with paper tape and joint compound.Paper tape and joint
compound may be omitted when gypsum boards are supplied with square edges.Exposed screw heads covered with joint
compound.
6.Batts and Blankets*—
Systems A,B,E,F,G,H,I
(Optional)—Mineral wool or glass fiber batts partially or completely filling stud cavity.Any mineral wool or glass fiber batt
mineral bearing the UL Classification Marking as to Fire Resistance.
Systems C&D
Min 3 in. (System C)and min 1-1/2 in. (System D)thick mineral wool batts,friction fitted between the studs and floor and
ceiling runners.
THERMAFIBER INC—Type SAFE
7.Cementitious Backer Units*—(System 0)—Nom 1/2 or 5/8 in.thick panels,square edge,attached to studs over
gypsum wallboard with 1-5/8 in.long,Type S-12,corrosion resistant steel screws spaced 8 in.OC and staggered 8 in.from
gypsum wall board screws.Joints covered with glass fiber mesh tape.Vertical joints staggered one stud cavity from
gypsum wallboard joints.Horizontal joints staggered a min of 12 in.from the gypsum wallboard joints.
UNITED STATES GYPSUM CO—Type DCB
8.Laminating Adhesive*—(Optional,Not Shown)—Used to bond outer layer of Cementitious Backer Units(Item 7)to
inner layers of Gypsum Board(Item 4)in System D.ANSI A136.1 Type 1 organic adhesive applied with 1/4 in.square
notched trowel.See Adhesives(BYWR)in the Fire Resistance Directory or Adhesives(BJLZ)in the Building Materials
1 tr v/Matnhcse.iii.com/cQi-bin/XYV/template/LISEXT/1FRAME/showpage.html?name=BX... 4/1/2013
/04� � City of Tybee Island, Georgia
1, 912-472-5033 or 912-472-5031 - Fax 912-786-9539
7)
/ - /9L APPLICATION FOR BUILDING PERMIT
Property Address: 6 3 / 5 m oil LE K., 1'Cl/t - Li&oa •-® '/-Q2 9
Name Mailing Address Telephone
Home:
Owner 7312-0CANI Cell:
Architect or _
Engineer cove1l2. r1� �. G 1 ,evul gE 762-7q1-HD
ZA .3 3
Office:
Contractor -D)t/ rer� Lit 6i S Cell:
(Check all that apply)
❑ Single Family ❑ Discovery/Tearout ❑ Demolition of Structure
El Duplex ❑ Footprint Changes- ❑ Other
❑ ulti-Family units new square feet
Commercial a units heated/cooled
Details of Project: /—CJ /A/ 1 R.. Tr 'V •- PeA i1 A
'-/t/-161, 116 ' -7\1■).Fz,', .K. kx)jr-V-2 - V J\■),-) L,_- A--/---) 'e2--i-i\A at/7(//1
V 1z,1/ C) ,
Estimated Cost of Construction: $ 1`,+® (materials + labor+ profit/overhead)
If applicable, attach a copy of the certified elevation certificate and/or survey of the property. Depending upon
the scope of the work, two sets of construction drawings and/or a site plan may be required.
Year Built: Listed on National Historic Register or located within a National Historic District? Y / N
*Buildings older than 50 years may be eligible to be listed on the State/National Register. With this designation,you
may be eligible to take advantage of various tax incentive programs while preserving the heritage of Tybee Island.
*Also see the Tybee Island Land Development Code Article 14: Historic Preservation
During construction:
On-sitmestroom faci'ti s will be p ovided through O�-"u'r&�`-- . Construction debris will be disposed
by vi - r /V by means of lL I i I understand that I must comply with zoning,flood
damage control, building, fire, shore protection and wetland ordinances, FEMA regulations and all applicable codes and
regulations. I realize that I must ensure the adequacy of drainage of this property so that surrounding property is in no way
adversely affected as required by Article 16, Stormwater Management. I accept responsibility for any corrective action that
may be necessary to restore drainage impaired b .is permitted co truction.
Date: 3-2.. l - Signature of Applicant:
,-lit/ FEES c °^^"-,
Printed Name { �rf f _ \��V Permit
Inspections
Note: A permit normally takes 7 to 10 days to process Cap Cost Rec
Water Tap
Approvals: i.n.t re D.te Sewer Stub
(
Planning &Zoning Manager L) ;, 3- r- , Eng. Fees
Building Official MIFTEF Aid to Const.
Water/Sewer
Storm/Drainage
City Manager
TOTAL
LEAD-BASED PAINT RRP RULES
Ordinary renovation and maintenance activities can create dust that contains lead. Contractors who perform
renovation, repairs, and painting jobs in pre-1978 housing and child-occupied facilities must, before beginning
work, provide owners, tenants, and child-care facilities with a copy of EPA's lead hazard information pamphlet
Renovate Right: Important Lead Hazard information for Families, Child Care Providers, and Schools.
Contractors must document compliance with this requirement. After April 22, 2010, federal law will require you
to be certified and to use lead-safe work practices. Georgia Environmental Protection Division Lead-Based
Paint and Asbestos Program (404) 363-7026.
Projects must be done by a Certified Lead Renovation Firm AND a Certified Renovator
When disturbing lead-based painted or coated surfaces or components more than 6 ft2 per interior
room or 20 ft2 of exterior surfaces AND all window replacements and partial demolitions of any size.
* * * * * * * * * * * * * * * * ** * * *
Asbestos/Environmental Notification to Georgia EPD for
Projects Involving Demolition, Wrecking, or Renovation
The undersigned hereby acknowledges that the issuance of this permit does not in any way grant permission
to the owner, owner's representative, or permit holder to proceed with demolition, wrecking, or renovation of a
structure prior to the filing of any required ten (10) day "Project Notification for Asbestos Renovation
Encapsulation or Demolition" form in accordance with the Georgia Asbestos Rules. The Georgia
Environmental Protection Division administers the rules. In most cases, the rules require both the owner and
the involved contractors to assure the portion of the building involved in the project is thoroughly inspected by
an Accredited Asbestos Inspector for materials that contain asbestos; and the removal of the asbestos before
renovation, wrecking, or demolition begins almost without exemption. Georgia EPD requires a completed
demolition notification from be submitted 10 workings days in advance even if no asbestos is present in the
building. Further guidance for regulatory compliance and contact telephone numbers are provided by the
brochures entitled Asbestos & Renovation and Asbestos and Demolition. Other environmental issues such
as asbestos removal techniques, lead abatement, ground contamination, or unusual site conditions may have
EPD regulations that could affect the project.
* * * * * * * * * * * ** * * * * * * * *
BMPs
While BMP deficiencies are not necessarily the fault of the owner or his agent, BMPs are their responsibility.
Two areas of deficiencies are in the most basic and common BMPs; Co — Construction Exit and Sd1 —
Sediment Barrier. Correct installation information can be found in the Field Manual for Erosion and Sediment
Control in Georgia, Fourth Edition 2002, Georgia Soil and Water Conservation Commission;
http://www.gaswcc.org/docs/field_manual_4ed.pdf.
Problems with the Co is not limited to the installation, but to material. The stone will be a representation of
1.5"-3.5" stone or larger.
Type A sediment barriers have been installed where Type C is required and shown on the permit drawings.
Where two rows are called for they will be installed with a separation that allows for the first one to fail (fall
over) without impacting the second one. The complete assembly and installation must be compliant; steel or
wood posts, post spacing, Type C or A.
Ck_.,()._"..., (-) 's ZA-1, -2----
Signature for receipt o Lead Paint, Asbestos, and BMP notices. Date
\ ---,----
Printed Name